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A decade since the introduction of DAA treatment, we aimed to assess its roll\u2010out and associated impact in reducing HCV prevalence among PWID in Scotland, as part of a treatment\u2010as\u2010prevention (TasP) strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      National bio\u2010behavioural surveys of PWID (recruited at services providing injecting equipment) between 2010 and 2023 (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200916\u2009973), involving a questionnaire and blood spot sample (tested for HCV\u2010antibodies and HCV\u2010RNA), were used to examine treatment uptake and HCV viraemia prevalence (overall and among those with antibodies) for Tayside, Greater Glasgow &amp; Clyde (GGC), and Rest of Scotland (RoS). We used a flexible Bayesian logistic regression model to estimate HCV prevalence and probability of having achieved an 80% reduction in HCV prevalence since 2015.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2015\u201316 and 2022\u201323, uptake of DAAs (ever) increased 2.7\u2010, 5.6\u2010 and 4.5\u2010fold to 95%, 78% and 76% in Tayside, GGC and RoS, respectively. Over this period, observed viraemia prevalence declined to 4%, 16% and 15% (involving 86%, 65% and 53% decline) in Tayside, GGC and RoS, respectively. In Tayside, modelled viraemia prevalence among those with antibodies declined from 62% in 2015 to 11% in 2023, with a 53% probability that the WHO proxy target of an 80% reduction in HCV prevalence was met.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study provides real\u2010world evidence for TasP, demonstrating that HCV elimination among PWID is feasible through community\u2010wide scale\u2010up of DAAs and population\u2010level monitoring surveys.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70771","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T07:36:01Z","timestamp":1782459361000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Antiviral Therapy Scale\u2010Up Among People Who Inject Drugs in Scotland: Regional Evidence of Hepatitis C Virus Elimination"],"prefix":"10.1111","volume":"46","author":[{"given":"Norah E.","family":"Palmateer","sequence":"first","affiliation":[{"name":"Glasgow Caledonian University  Glasgow UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantelis","family":"Samartsidis","sequence":"additional","affiliation":[{"name":"MRC Biostatistics Unit University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Biggam","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Glasgow UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"McAuley","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Glasgow UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Incognita Data Science  Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Dillon","sequence":"additional","affiliation":[{"name":"University of Dundee  Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen T.","family":"Barclay","sequence":"additional","affiliation":[{"name":"Glasgow Royal Infirmary  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha J.","family":"Shepherd","sequence":"additional","affiliation":[{"name":"West of Scotland Specialist Virology Centre  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory N.","family":"Gunson","sequence":"additional","affiliation":[{"name":"West of Scotland Specialist Virology Centre  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Desai","sequence":"additional","affiliation":[{"name":"UK Health Security Agency  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duncan","family":"McCormick","sequence":"additional","affiliation":[{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"De Angelis","sequence":"additional","affiliation":[{"name":"MRC Biostatistics Unit University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9864-459X","authenticated-orcid":false,"given":"Matthew","family":"Hickman","sequence":"additional","affiliation":[{"name":"University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon J.","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Glasgow UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.54394\/CJQU6666"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(19)30085\u20108"},{"key":"e_1_2_12_4_1","volume-title":"Surveillance of Hepatitis C in Scotland. 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